Individual provider Active NPI

Rebecca Gail Weisenthal

  • Psychologist
  • Charlotte, NC
National Provider Identifier
1124293824
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3026 Issued in NC
Practice address
1923 J N Pease PL Ste 104
Charlotte, NC 28262-4534
Phone
(704) 604-2325
NPI assigned
Apr 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3026 NC Primary

Addresses

Primary practice location

1923 J N Pease PL Ste 104
Charlotte, NC 28262-4534

Mailing address

1923 J N Pease PL Ste 104
Charlotte, NC 28262-4534
Phone (704) 604-2325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080515000316 NC Practitioner - Clinical Psychologist 7416026679 Practice locations: Charlotte, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1923 J N Pease PL
Suite 104
Charlotte, NC 28262-4534
Phone (704) 604-2325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1124293824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 J N PEASE PL STE 104",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624534",
            "telephone_number": "704-604-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 J N PEASE PL STE 104",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624534",
            "telephone_number": "704-604-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISENTHAL",
        "first_name": "REBECCA",
        "middle_name": "GAIL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.